anticoronary insufficiency drugs

Question 1

coronary artery insufficiency

Answer 1

angina

Question 2

altherosclerosis

Answer 2

1) 1 killer in america
- atherosclerosis heart disease, or ischemic heart disease
- plaque narrows arteries
2) etiology
- genetics, diabetes, hypertension, high cholesterol, smoke, alcohol, tress

Question 3

symptoms of CAD

Answer 3

1) nausea, burping, discomfort in stomach
2) angina pectoris
- heart attack, chest pai, referred pain to left side
3) can be triggered by cold and big meal
4) unstable angina, spastic angina, myocardial infarction, heart failure, arrhythmias, death

Question 4

diagnosis

Answer 4

1) fam history
2) risk factors
3) symptoms
4) ECG
5) computer tomography
6) angiography
7) blood test (LDL, HDL)

Question 5

coronary artery anatomy review

Answer 5

1) arise from aorta
2) right coronary a
- posterior interventricular
3) left coronary a
- anterior interventricular

Question 6

anti coronary insufficient drugs

Answer 6

1) reduce cardiac oxygen demand
- control HR, contractility, and workload of the heart
2) increase oxygen delivery
- improve coronary blood flow

Question 7

beta adrengeric receptor blocker

Answer 7

1) propranolol
2) reduce O2 consumption
- decrease HR and contractility
- negative chronotropic and inotropic
2) Reduce salt and water retention by decreasing renin release from kidney
3) reduction of sympathetic drive
4) used for prophylaxis of exertional angina
5) often combined with other drugs

Question 8

Ca channel blockers

Answer 8

1) verapamil, nefidipine, ditiazem
2) reduce cardiac muscle contraction
3) decrease HR
4) decrease vascular smooth muscle contraction
- vasodilation, reduce total peripheral resistance
5) increase coronary blood flow
6) side effects: flushing, dizzy, fainting, reflex tachycardia, gingival swelling

Question 9

organic nitrates

Answer 9

1) nitroglycerin
1) release of NO which activated guanyl cyclase and cGMP, activates myosin light chain, reduce Ca2+ influx
2) relax smooth muscles and vasodilation
3) reduction of cardiac filling (preload, venous dilation predominates, primary mechanism)
4) reduce blood vessel resistance, reduce afterload, dilate coronary vessel
5) reversal of coronary vasospasm
6) can treat raynauds disease too

Question 10

organic nitrates administration

Answer 10

1) nitroglycerin can be admin sublingual
- emergency
- or tablets and topicals
2) side effects: headache, dizzy, orthostatic hypotension
3) nitrate tolerance
- decreased conversion to NO, desensitization to GC
4) relief symptoms by reducing oxygen demand, do evidence it reduce mortality

Question 11

endothelium dependent relaxation

Answer 11

1) hydralazine
2) acts on artery and reduce afterload
2) endothelial dependent relaxation
- acetylcholine, histamine, bradykin etc trigger synthesis of NO

Question 12

K+ channel activators (minoxidil)

Answer 12

• increase K+ channel conductance and leads to hyperpolarization of vascular smooth muscle and vessel dialation
  2) decreases Ca2+ influx

Question 13

phosphodiesterase 5 (inhibitors)

Answer 13

1) sildenafil
2) prevent degradation of cGMP in vascular smoot muscle
3)

Question 14

other medications

Answer 14

1) antiplatelet
2) lipid lowering drugs
3) coronary angioplasty and stent
4) coronary bypass
5) lifestyle

Question 15

summary chart

Answer 15

1) know the chart

Question 16

recommendatiosn for dentists

Answer 16

1) obtain medical history and consult PCP
2) obtain and monitor vitals
3) avoid epinephrine
4) be prepared for emergencies situations

Question 17

hypertension

Answer 17

decrease BP

Question 18

congestive heart failure

Answer 18

1) increase CO and decrease O2 consumption

Question 19

coronary artery insufficiency

Answer 19

1) increase flow through coronary arteries and decrease O2 consumption by the heart